Healthcare Provider Details

I. General information

NPI: 1144157389
Provider Name (Legal Business Name): DAVID MICHAEL GONZALES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W CYPRESS AVE
VISALIA CA
93277-8300
US

IV. Provider business mailing address

5000 W CYPRESS AVE
VISALIA CA
93277-8300
US

V. Phone/Fax

Practice location:
  • Phone: 559-730-7300
  • Fax:
Mailing address:
  • Phone: 559-730-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: